http://stroke.ahajournals.org/content/49/2/377?etoc=
Zhengbao Zhu, Tan Xu, Daoxia Guo, Xinfeng Huangfu, Chongke Zhong, Jingyuan Yang, Aili Wang, Chung-Shiuan Chen, Yanbo Peng, Tian Xu, Jinchao Wang, Yingxian Sun, Hao Peng, Qunwei Li, Zhong Ju, Deqin Geng, Jing Chen, Yonghong Zhang, Jiang He
https://doi.org/10.1161/STROKEAHA.117.019476
Stroke. 2018;49:377-383
Originally published January 10, 2018
Zhengbao Zhu
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Tan Xu
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Daoxia Guo
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Xinfeng Huangfu
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Chongke Zhong
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Jingyuan Yang
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Aili Wang
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Chung-Shiuan Chen
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Yanbo Peng
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Tian Xu
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Jinchao Wang
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Yingxian Sun
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Hao Peng
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Qunwei Li
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Zhong Ju
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Deqin Geng
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Jing Chen
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Yonghong Zhang
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
Jiang He
From the Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China (Z.Z., T.X., D.G., X.H., C.Z., J.Y., A.W., T.X., H.P., Y.Z.); Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C.Z., C.-S.C., J.C., J.H.); Department of Epidemiology, School of Public Health, Guizhou Medical University, Guiyang, China (J.Y.); Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China (Y.P.); Department of Neurology, Affiliated Hospital of Nantong University, Jiangsu, China (T.X.); Department of Neurology, Yutian County Hospital, Hebei, China (J.W.); Department of Cardiology, the First Affiliated Hospital of China Medical University, Liaoning (Y.S.); Department of Epidemiology, School of Public Health, Taishan Medical College, Shandong, China (Q.L.); Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Inner Mongolia, China (Z.J.); Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Jiangsu, China (D.G.); and Department of Medicine, Tulane University School of Medicine, New Orleans, LA (J.C., J.H.).
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Abstract
Background and Purpose—Serum hepatocyte growth factor (HGF) is positively associated with poor prognosis of heart failure and myocardial infarction, and it can also predict the risk of ischemic stroke in population. The goal of this study was to investigate the association between serum HGF and prognosis of ischemic stroke.
Methods—A total of 3027 acute ischemic stroke patients were included in this post hoc analysis of the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke). The primary outcome was composite outcome of death or major disability (modified Rankin Scale score ≥3) within 3 months.
Results—After multivariate adjustment, elevated HGF levels were associated with an increased risk of primary outcome (odds ratio, 1.50; 95% confidence interval, 1.10–2.03; Ptrend=0.015) when 2 extreme quartiles were compared. Each SD increase of log-transformed HGF was associated with 14% (95% confidence interval, 2%–27%) increased risk of primary outcome. Adding HGF quartiles to a model containing conventional risk factors improved the predictive power for primary outcome (net reclassification improvement: 17.50%, P<0.001; integrated discrimination index: 0.23%, P=0.022). The association between serum HGF and primary outcome could be modified by heparin pre-treatment (Pinteraction=0.001), and a positive linear dose–response relationship between HGF and primary outcome was observed in patients without heparin pre-treatment (Plinearity<0.001) but not in those with heparin pre-treatment.
Conclusions—Serum HGF levels were higher in the more severe stroke at baseline, and elevated HGF levels were probably associated with 3-month poor prognosis independently of stroke severity among ischemic stroke patients, especially in those without heparin pre-treatment. Further studies from other samples of ischemic stroke patients are needed to validate our findings.
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